Gag for Psychiatrists

The doctor-patient relationship is an intimate one. Most states consider such relationships privileged, and therefore what a man tells his doctor about his ill ness is as inadmissible in court as what he tells his lawyer or spouse. But what of the state-employed psychiatrist who treats an accused criminal? If the crim inal enters a defense of insanity, can the psychiatrist be a witness against him? Now the Minnesota Supreme Court has refused to create an exception for state psychiatrists. A doctor-patient relationship is a doctor-patient relationship, said the court, no matter who employs the doctor.

Sine Qua N/on. The case under review was that of Albert Alfred Fontana, a former state trapshooting champion, who had shot and killed his estranged wife after she refused a reconciliation. Found incapable of standing trial because of insanity, he was placed in a state mental hospital where, after a few months under the care primarily of Dr. Carl Schwartz, he recovered enough to face a court. He pleaded not guilty by virtue of insanity, and the prosecution called Dr. Schwartz, who, over defense objections, stated that "Mr. Fontana was aware that he was doing something wrong."

Speaking for the unanimous eight-man court, Justice William P. Murphy pointed out that the statute barring a doctor's testimony without patient's consent "makes no distinction between 'public' and 'private' physician-patient relationships. The purpose behind the statute is to inspire confidence in patients to make full disclosure of symptoms and conditions to physicians. Such confidence is deemed necessary to the efficacy of treatment. This is especially so in the case of state hospitals for the mentally ill, where complete confidence in the attending physicians is a sine qua non to the cure."

Justice Murphy added that it is still permissible for a state physician to testify against a defendant who has agreed to the physician's examination knowing that its purpose is to secure evidence that can be used against him. But, said Murphy: "It does not seem to us that the state should have to rely on the privileged testimony of a state-employed psychiatrist to prove that patient-defendants were not insane at the moment of their crimes."

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